Radio frequency ablation electrode for otitis media minimally invasive surgery and using method thereof
阅读说明:本技术 一种用于中耳炎微创手术的射频消融电极及其使用方法 (Radio frequency ablation electrode for otitis media minimally invasive surgery and using method thereof ) 是由 张志钢 林敏� 于 2020-04-14 设计创作,主要内容包括:本发明提供一种用于中耳炎微创手术的射频消融电极及其使用方法,所述射频消融电极包括相互连接的手柄和电极,电极为管状结构,包括内管电极和外管电极,内外管电极分别和电源的两极连接,且外管电极的管身套设于内管电极的管身之外,外管电极和内管电极的头端同向且均裸露,构成电极的电极头端,内管电极的外表面设为绝缘面,内管电极和外管电极的管身相互绝缘,二者的头端可以通过生理盐水实现电导通,使得电极头端形成等离子场,对鼓膜组织消融打孔。本发明突破了传统的机械刺穿、电烧或激光等高温刺穿手术方式的思维定势,利用低温等离子原理,在电极头端形成等离子场,在较低的温度下对鼓膜组织进行消融打孔,提高了中耳炎微创手术的效率和治疗效果。(The invention provides a radio frequency ablation electrode for otitis media minimally invasive surgery and a using method thereof, the radio frequency ablation electrode comprises a handle and an electrode which are mutually connected, the electrode is of a tubular structure and comprises an inner tube electrode and an outer tube electrode, the inner tube electrode and the outer tube electrode are respectively connected with two poles of a power supply, a tube body of the outer tube electrode is sleeved outside the tube body of the inner tube electrode, the head ends of the outer tube electrode and the inner tube electrode are exposed in the same direction to form an electrode head end of the electrode, the outer surface of the inner tube electrode is provided with an insulating surface, the tube bodies of the inner tube electrode and the outer tube electrode are mutually insulated, the head ends of the inner tube electrode and the outer tube electrode can be electrically conducted through physiological saline, so that a. The invention breaks through the thinking set of the traditional high-temperature puncture operation modes such as mechanical puncture, electrocautery or laser and the like, utilizes the low-temperature plasma principle to form a plasma field at the end of the electrode tip, carries out ablation and perforation on tympanic membrane tissues at lower temperature and improves the efficiency and the treatment effect of the otitis media minimally invasive operation.)
1. A radio frequency ablation electrode for minimally invasive otitis media surgery, comprising: including interconnect's handle and electrode, the electrode is the tubular structure, including inner tube electrode and outer tube electrode, inner tube electrode and outer tube electrode are connected with the two poles of the earth of power respectively, just the stack shell of outer tube electrode is located outside the stack shell of inner tube electrode, the head end syntropy of outer tube electrode and inner tube electrode just all exposes, constitutes the electrode head end of electrode, the surface of inner tube electrode is established to insulating face, makes inner tube electrode and outer tube electrode the stack shell is insulating each other, and inner tube electrode and outer tube electrode head end can realize the electric conductance through normal saline, make electrode tip end formation plasma field melts to tympanic membrane tissue and punches.
2. The radio frequency ablation electrode of claim 1, wherein: the electric conduction of the head ends of the inner tube electrode and the outer tube electrode can be realized through normal saline, so that a plasma field is formed at the end of the electrode tip to perform ablation and perforation on tympanic membrane tissues, and the method comprises the following steps:
the first mode is as follows: a gap penetrating through the electrode is arranged between the insulating surface and the outer tube electrode, a water injection tube is communicated with the gap, the inner tube electrode is a hollow tube, a water suction tube is communicated with the hollow pipeline of the inner tube electrode, physiological saline sequentially reaches the head end of the electrode through the water injection tube and the gap, a plasma field is formed under the action of an electromagnetic field between the outer tube electrode and the inner tube electrode to perform ablation and punching on the tympanic membrane, and meanwhile, the physiological saline is continuously sucked out from the hollow pipeline of the inner tube electrode to the water suction tube;
the second mode is as follows: a gap penetrating through the electrode is arranged between the insulating surface and the outer tube electrode, a water injection tube is communicated with the gap, the inner tube electrode is a hollow tube or a solid tube which is not used for absorbing water, and physiological saline reaches the electrode tip end through the water injection tube and the gap in sequence to form a plasma field to perform ablation and punching on the tympanic membrane;
the third mode is as follows: a gap is arranged between the insulating surface and the outer tube electrode, the gap is not communicated with the outside, or no gap is arranged between the insulating layer and the outer tube electrode, the insulating layer and the outer tube electrode are in direct contact, the inner tube electrode is a hollow tube or a solid tube which is not used for absorbing water, and the physiological saline attached to the ends of the inner tube electrode and the outer tube electrode forms a plasma field under the action of an electromagnetic field between the two electrodes to perform ablation and punching on the tympanic membrane;
the fourth mode is that: a water absorption material is arranged between the insulating surface and the outer tube electrode, the inner tube electrode is a hollow tube or a solid tube which is not used for absorbing water, physiological saline in the water absorption material is attached to the head ends of the inner tube electrode and the outer tube electrode, and a plasma field is formed under the action of an electromagnetic field between the two electrodes to perform ablation and punching on the tympanic membrane;
the fifth mode is as follows: the inner tube electrode is the hollow tube, a water injection pipe with the cavity pipeline intercommunication of inner tube electrode, the insulating layer with there is not clearance or the direct contact with outside intercommunication between the outer tube electrode, normal saline via reach behind the cavity pipeline of water injection pipe and inner tube electrode and outer tube electrode head end form the plasma field and melt and punch the tympanic membrane under the electromagnetic field effect between the two poles of the earth.
3. The radio frequency ablation electrode of claim 2, wherein: the inner tube electrode and the outer tube electrode are made of metal materials; the outer surface of the inner tube electrode is coated with an insulating layer to form the insulating surface, and the outer surface of the outer tube electrode is coated with an outer insulating layer.
4. The radio frequency ablation electrode according to claim 3, wherein: at the electrode head end, the positional relationship of the inner tube electrode, the insulating layer, the outer tube electrode and the outer insulating layer is one of the following schemes:
the first scheme is as follows: the head end of the insulating layer does not protrude out of the head end of the inner tube electrode, the head end of the outer tube electrode does not protrude out of the head end of the insulating layer, and the head end of the outer insulating layer does not protrude out of the head end of the outer tube electrode;
the second scheme is as follows: the head end of the insulating layer does not protrude out of the head end of the inner tube electrode, the head end of the outer tube electrode does not protrude out of the head end of the insulating layer, and the head end of the outer insulating layer is flush with the head end of the inner tube electrode or protrudes out of the head end of the inner tube electrode;
in the third scheme: the head end of the inner tube electrode does not protrude out of the head end of the insulating surface, the head end of the outer tube electrode is flush with the head end of the insulating surface or protrudes out of the head end of the insulating surface, and the head end of the outer insulating layer does not protrude out of the head end of the outer tube electrode;
the above three schemes are all applicable to the first mode and the second mode;
the third, fourth, and fifth modes are applicable only to the second and third modes.
5. The radio frequency ablation electrode of claim 4, wherein: in the first scheme, the distance between the end face of the head end of the insulating layer and the end face of the head end of the inner tube electrode is 0-1.5mm, the distance between the end face of the head end of the outer tube electrode and the end face of the head end of the inner tube electrode is 0-3.0mm, and the distance between the end face of the head end of the outer insulating layer and the end face of the head end of the outer tube electrode is 0-3.5 mm; in the second scheme, the distance between the end face of the head end of the insulating layer and the end face of the head end of the inner tube electrode is 0-1.5mm, the distance between the end face of the head end of the outer tube electrode and the end face of the head end of the inner tube electrode is 0-3.0mm, and the distance between the end face of the head end of the outer insulating layer and the end face of the head end of the inner tube electrode is 0-1.0 mm; in the third scheme, the distance between the head end surface of the insulating surface and the head end surface of the inner tube electrode is 0-2.0mm, the distance between the head end surface of the outer tube electrode and the head end surface of the insulating surface is 0-1.5mm, and the distance between the head end surface of the outer insulating layer and the head end surface of the outer tube electrode is 0-2.0 mm.
6. A radio frequency ablation electrode according to claim 4 or 5, wherein: the electrodes comprise children and adults; the radial dimensions of the parts of the children money are as follows: the outer diameter of the inner tube electrode is 0.5-1.5mm, and the outer insulating layer, namely the outer diameter of the electrode rod of the electrode, is 0.9-2.9 mm; the adult model has the following radial dimensions of each part: the outer diameter of the inner tube electrode is 0.6-1.6mm, and the outer diameter of the outer insulating layer, namely the outer diameter of the electrode rod of the electrode, is 1.2-3.2 mm.
7. The radio frequency ablation electrode according to claim 6, wherein: the external diameter of children's money's outer insulating layer is 1.9mm, adult's money's outer insulating layer's external diameter is 2.2 mm.
8. The radio frequency ablation electrode of claim 1, wherein: when a gap exists between the outer tube electrode and the insulating surface, a plurality of electrode fixing mechanisms are arranged between the tail end and the head end of the electrode, the electrode fixing mechanisms are arranged between the insulating surface and the outer tube electrode and are used for fixing the relative positions of the outer tube electrode and the inner tube electrode, the electrode fixing mechanisms are first salient points protruding from the inner wall of the outer tube electrode to the insulating surface, the vertexes of the first salient points are abutted or close to the outer surface of the insulating surface, or the electrode fixing mechanisms are second salient points protruding from the inner surface of the insulating surface to the outer tube electrode, and the vertexes of the second salient points are abutted or close to the inner wall of the outer tube electrode.
9. The radio frequency ablation electrode of claim 8, wherein: the gap is an annular gap, and the plurality of electrode fixing mechanisms form one or more electrode fixing rings distributed in the annular gap between the tail end and the head end of the electrode.
10. The radio frequency ablation electrode of claim 1, wherein: the handle includes shell and handle backshell before the handle, shell is the dog-ear structure before the handle, the trailing end connection of dog-ear the handle backshell, the front end of dog-ear is used for fixing the electrode, the angle design of dog-ear is handheld for the operator the handle backshell and will the electrode is gone deep into in the human duct.
11. The radio frequency ablation electrode according to claim 10, wherein: the handle further comprises a handle insert which is embedded between the inner wall of the handle front shell and the outer wall of the electrode and extends out of the front end of the bevel of the handle front shell to further cover a section of the outer surface of the electrode.
12. The radio frequency ablation electrode according to claim 11, wherein: the electrode front section is set to be an arc with a curvature greater than or equal to R10.
13. A method of using a radio frequency ablation electrode for minimally invasive otitis media, the radio frequency ablation electrode employing the first modality of claim 2, comprising the steps of:
s1, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s2, firstly, turning on a water injection and water absorption control switch of the physiological saline of the electrode, enabling the physiological saline to reach the electrode tip end through a gap between an outer tube electrode and an outer insulation surface of an inner tube electrode to form a connection water bead, then turning on a power switch of the electrode, conducting the inner tube electrode and the outer tube electrode to generate a plasma field, and continuously propelling the electrode to enable the plasma field to ablate and perforate the tympanic membrane, and meanwhile, enabling the physiological saline to be continuously sucked out through a hollow pipeline of the inner tube electrode;
and S3, closing a power switch of the electrode and a water injection and absorption control switch of the physiological saline, and taking out the endoscope and the electrode.
14. A method of using a radio frequency ablation electrode for minimally invasive otitis media surgery, the radio frequency ablation electrode employing the second modality of claim 2, comprising the steps of:
s1, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s2, turning on a power switch of the electrode and a water injection control switch of the physiological saline, enabling the physiological saline to reach the head end of the electrode through a gap between an outer tube electrode and an insulating layer outside the inner tube electrode, conducting the inner tube electrode and the outer tube electrode, generating a plasma field, and continuously propelling the electrode to enable the plasma field to ablate and perforate the tympanic membrane;
and S3, closing a power switch of the electrode and a water injection control switch of the physiological saline, and taking out the endoscope and the electrode.
15. A method of using a radio frequency ablation electrode for minimally invasive otitis media, the radio frequency ablation electrode employing the third modality of claim 2, comprising the steps of:
s1, attaching physiological saline to the electrode head end of the handheld radio-frequency ablation electrode;
s2, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s3, turning on a power switch of the electrode, switching on the power of the electrode, enabling the physiological saline at the head end of the electrode to conduct the inner tube electrode and the outer tube electrode, generating a plasma field, and continuing to propel the electrode to enable the plasma field to ablate and perforate the tympanic membrane;
and S4, closing a power switch of the electrode, and taking out the endoscope and the electrode.
16. A method of using a radio frequency ablation electrode for minimally invasive otitis media surgery, the radio frequency ablation electrode in the fourth mode of claim 2, comprising the steps of:
s1, enabling the water absorption material to absorb enough physiological saline;
s2, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s3, turning on a power switch of the electrode, switching on the power of the electrode, enabling the physiological saline at the head end of the electrode to conduct the inner tube electrode and the outer tube electrode, generating a plasma field, and continuing to propel the electrode to enable the plasma field to ablate and perforate the tympanic membrane;
and S4, closing a power switch of the electrode, and taking out the endoscope and the electrode.
17. A method of using a radio frequency ablation electrode for minimally invasive otitis media, the radio frequency ablation electrode employing the fifth modality of claim 2, comprising the steps of:
s1, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s2, turning on a power switch of the electrode and a water injection control switch of the physiological saline, enabling the physiological saline to reach the electrode head end through a hollow pipeline of the inner tube electrode, conducting the inner tube electrode and the outer tube electrode, generating a plasma field, and continuously propelling the electrode to enable the plasma field to perform ablation perforation on the tympanic membrane;
and S3, closing a power switch of the electrode and a water injection control switch of the physiological saline, and taking out the endoscope and the electrode.
Technical Field
The invention relates to the technical field of medical instruments, in particular to a radio frequency ablation electrode for otitis media minimally invasive surgery and a using method thereof.
Background
Otitis media is an inflammatory condition affecting all or part of the structure of the middle ear (including eustachian tube, tympanic cavity, tympanic sinus and mastoid air chamber), and is well developed in children. Otitis media is different in type and treatment, and is roughly divided into two types: secretory otitis media is mainly caused by obstructed eustachian tubes, which is commonly called as nasal obstruction caused by cold, rhinitis and the like, so that the pressure of the middle ear is changed, liquid is generated, and secretory otitis media is formed. As long as no structural abnormality exists, after the cold is cured, the nose is ventilated, the eustachian tube function is recovered, the liquid in the middle ear can be discharged, and the secretory otitis media is self-healed. Can take cold medicine and medicine for promoting the activity of the loiter, and the tympanic membrane puncture treatment is needed if the liquid is too much; secondly, suppurative otitis media: generally, the traditional Chinese medicine has the meaning of inflammation, can heal the ears naturally slightly, has the symptoms of ear purulence, hearing loss and the like seriously, and is mainly treated by antibiotics; surgery is required for the formation of cholesteatoma in a more severe manner.
Tympanocentesis is a method for treating otitis media commonly used in clinic at present, and the treatment method is that a tympanic membrane is punctured mechanically, then liquid medicine is injected into a tympanic cavity, and effusion containing pus in the tympanic cavity gradually flows out. However, it has been found clinically that the conventional tympanocentesis has the following significant drawbacks: because the mechanical puncture belongs to mechanical injury to the tympanic membrane tissue, therefore the tympanic membrane healing is too fast, about a week, and the time of effusion thorough discharge generally needs at least one month to lead to the effusion in the tympanic cavity not clean just healing yet, need puncture again, puncture even more times is repeated, cause doctor's complex operation, more can increase patient's misery, delay the treatment process, on the other hand, be difficult to control the depth of penetration when the puncture operation, if the tympanic membrane incision knife tip pierces too deeply, the vascular nerve plexus on tympanum mucosa surface of well ear cavity inner wall is wounded easily, the security is low, operation requirement to the doctor is high.
Another approach that can be taken is laser puncture surgery, which has the disadvantage of permanent burns to the tympanic membrane tissue, which is difficult to heal after treatment, which is clearly not a desirable result for both the physician and the patient.
Disclosure of Invention
In order to solve the defects of the prior art, the invention aims to provide a surgical method and a surgical instrument which do not cause mechanical injury to the tympanic membrane, have proper healing time, do not need multiple times of puncture, are easy to operate and cause as little pain to patients as possible.
The purpose of the invention is realized by the following technical scheme:
the utility model provides a radio frequency ablation electrode for otitis media minimal access surgery, includes interconnect's handle and electrode, the electrode is the tubular structure, including inner tube electrode and outer tube electrode, inner tube electrode and outer tube electrode are connected with the two poles of the earth of power respectively, just the stack shell of outer tube electrode is located outside the stack shell of inner tube electrode, the head end syntropy of outer tube electrode and inner tube electrode just all exposes, constitutes the electrode head end of electrode, the surface of inner tube electrode is established to insulating face, makes inner tube electrode and outer tube electrode the stack shell is insulating each other, and inner tube electrode and outer tube electrode head end can realize the electric conductance through normal saline, make electrode tip plasma end forms the field, melts to perforate to the tympanic membrane tissue.
Preferably, the tips of the inner tube electrode and the outer tube electrode can be electrically conducted through physiological saline, so that the electrode tip forms a plasma field to perform ablation and perforation on tympanic membrane tissues, and the method comprises the following steps:
the first mode is as follows: a gap penetrating through the electrode is arranged between the insulating surface and the outer tube electrode, a water injection tube is communicated with the gap, the inner tube electrode is a hollow tube, a water suction tube is communicated with the hollow pipeline of the inner tube electrode, physiological saline sequentially reaches the head end of the electrode through the water injection tube and the gap, a plasma field is formed under the action of an electromagnetic field between the outer tube electrode and the inner tube electrode to perform ablation and punching on the tympanic membrane, and meanwhile, the physiological saline is continuously sucked out from the hollow pipeline of the inner tube electrode to the water suction tube;
the second mode is as follows: a gap penetrating through the electrode is arranged between the insulating surface and the outer tube electrode, a water injection tube is communicated with the gap, the inner tube electrode is a hollow tube or a solid tube which is not used for absorbing water, and saline reaches the electrode tip end through the water injection tube and the gap in sequence to form a plasma field to perform ablation and punching on the tympanic membrane;
the third mode is as follows: a gap is arranged between the insulating surface and the outer tube electrode, the gap is not communicated with the outside, or no gap is arranged between the insulating layer and the outer tube electrode, the insulating layer and the outer tube electrode are in direct contact, the inner tube electrode is a hollow tube or a solid tube which is not used for absorbing water, and physiological saline attached to the ends of the inner tube electrode and the outer tube electrode tip forms a plasma field under the action of an electromagnetic field between the two electrodes to perform ablation and punching on the tympanic membrane;
the fourth mode is that: a water absorption material is arranged between the insulating surface and the outer tube electrode, the inner tube electrode is a hollow tube or a solid tube which is not used for absorbing water, physiological saline in the water absorption material is attached to the head ends of the inner tube electrode and the outer tube electrode, and a plasma field is formed under the action of an electromagnetic field between the two electrodes to perform ablation and punching on the tympanic membrane;
the fifth mode is as follows: the inner tube electrode is a hollow tube, a water injection tube is communicated with the hollow pipeline of the inner tube electrode, a gap which is not communicated with the outside or direct contact is arranged between the insulating layer and the outer tube electrode, the physiological saline reaches the head ends of the inner tube electrode and the outer tube electrode after passing through the hollow pipelines of the water injection tube and the inner tube electrode, and a plasma field is formed under the action of an electromagnetic field between the two electrodes to melt and punch the tympanic membrane.
Preferably, the inner tube electrode and the outer tube electrode are both made of metal materials; the outer surface of the inner tube electrode is covered with an insulating layer to form the insulating surface, and the outer surface of the outer tube electrode is covered with an outer insulating layer.
Preferably, at the electrode tip, the positional relationship among the inner tube electrode, the insulating layer, the outer tube electrode, and the outer insulating layer is one of the following:
the first scheme is as follows: the head end of the insulating layer does not protrude out of the head end of the inner tube electrode, the head end of the outer tube electrode does not protrude out of the head end of the insulating layer, and the head end of the outer insulating layer does not protrude out of the head end of the outer tube electrode;
the second scheme is as follows: the head end of the insulating layer does not protrude out of the head end of the inner tube electrode, the head end of the outer tube electrode does not protrude out of the head end of the insulating layer, and the head end of the outer insulating layer is flush with or protrudes out of the head end of the inner tube electrode;
in the third scheme: the head end of the inner tube electrode does not protrude out of the head end of the insulating surface, the head end of the outer tube electrode is flush with the head end of the insulating surface or protrudes out of the head end of the insulating surface, and the head end of the outer insulating layer does not protrude out of the head end of the outer tube electrode;
the above three schemes are all applicable to the first mode and the second mode;
the third, fourth, and fifth modes are applicable only to the second and third modes.
Preferably, in the first scheme, the distance between the head end surface of the insulating layer and the head end surface of the inner tube electrode is 0-1.5mm, the distance between the head end surface of the outer tube electrode and the head end surface of the inner tube electrode is 0-3.0mm, and the distance between the head end surface of the outer insulating layer and the head end surface of the outer tube electrode is 0-3.5 mm; in the second scheme, the distance between the end face of the head end of the insulating layer and the end face of the head end of the inner tube electrode is 0-1.5mm, the distance between the end face of the head end of the outer tube electrode and the end face of the head end of the inner tube electrode is 0-3.0mm, and the distance between the end face of the head end of the outer insulating layer and the end face of the head end of the inner tube electrode is 0-1.0 mm; in the third scheme, the distance between the head end surface of the insulating surface and the head end surface of the inner tube electrode is 0-2.0mm, the distance between the head end surface of the outer tube electrode and the head end surface of the insulating surface is 0-1.5mm, and the distance between the head end surface of the outer insulating layer and the head end surface of the outer tube electrode is 0-2.0 mm.
Preferably, the electrodes include pediatric and adult versions; the radial dimensions of the parts of the children money are as follows: the outer diameter of the inner tube electrode is 0.5-1.5mm, and the outer insulating layer, namely the outer diameter of the electrode rod of the electrode, is 0.9-2.9 mm; the adult model has the following radial dimensions of each part: the outer diameter of the inner tube electrode is 0.6-1.6mm, and the outer diameter of the outer insulating layer, namely the outer diameter of the electrode rod of the electrode, is 1.2-3.2 mm.
Preferably, the outer diameter of the outer insulating layer for the children model is 1.9mm, and the outer diameter of the outer insulating layer for the adult model is 2.2 mm.
Preferably, when there is a gap between the outer tube electrode and the insulating surface, a plurality of electrode fixing mechanisms are provided between a tail end and a head end of the electrode, the plurality of electrode fixing mechanisms are provided between the insulating surface and the outer tube electrode for fixing the relative positions of the outer tube electrode and the inner tube electrode, the electrode fixing mechanisms are first protrusions protruding from an inner wall of the outer tube electrode toward the insulating surface, and apexes of the plurality of first protrusions are in contact with or close to an outer surface of the insulating surface, or the electrode fixing mechanisms are second protrusions protruding from an inner surface of the insulating surface toward the outer tube electrode, and apexes of the plurality of second protrusions are in contact with or close to an inner wall of the outer tube electrode.
Preferably, the gap is an annular gap, and the plurality of electrode fixing mechanisms form one or more electrode fixing rings distributed in the annular gap between the tail end and the head end of the electrode. More preferably, the electrode fixing ring is arranged at a position 10-15mm away from the end face of the head end of the inner tube electrode.
Preferably, the handle comprises a front handle shell and a rear handle shell, the front handle shell is of a folded angle structure, the tail end of the folded angle is connected with the rear handle shell, the front end of the folded angle is used for fixing the electrode, and the angle of the folded angle is designed to facilitate an operator to hold the rear handle shell to enable the electrode to penetrate into the ear canal of the human body. Preferably, the folding angle of the front shell of the handle is 10-50 degrees.
Preferably, the handle further comprises a handle insert which is embedded between the inner wall of the handle front shell and the outer wall of the electrode and extends out of the front end of the bevel of the handle front shell to further cover a section of the outer surface of the electrode.
Preferably, the front section of the electrode is formed in an arc shape having a curvature of R10 or more.
A method of using a radio frequency ablation electrode for minimally invasive otitis media surgery, the radio frequency ablation electrode adopting the first mode, comprising the following steps:
s1, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s2, firstly, turning on a water injection and water absorption control switch of the electrode normal saline, enabling the normal saline to reach the head end of the electrode through a gap between an outer tube electrode and an insulating layer outside the inner tube electrode to form a connecting water droplet, then turning on a power switch of the electrode, conducting the inner tube electrode and the outer tube electrode, generating a plasma field, continuously pushing the electrode, enabling the plasma field to perform ablation and perforation on the tympanic membrane, and meanwhile, enabling the normal saline to be continuously sucked out through a hollow pipeline of the inner tube electrode;
and S3, closing a power switch of the electrode and a water injection and absorption control switch of the physiological saline, and taking out the endoscope and the electrode.
Another method for using the rf ablation electrode for minimally invasive otitis media surgery, wherein the rf ablation electrode adopts the second method described above, and comprises the following steps:
s1, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s2, turning on a power switch of the electrode and a water injection control switch of the physiological saline, enabling the physiological saline to reach the head end of the electrode through a gap between an outer tube electrode and an insulating layer outside the inner tube electrode, conducting the inner tube electrode and the outer tube electrode, generating a plasma field, and continuously propelling the electrode to enable the plasma field to melt and perforate the tympanic membrane;
and S3, closing a power switch of the electrode and a water injection control switch of the physiological saline, and taking out the endoscope and the electrode.
Another method for using the rf ablation electrode for minimally invasive otitis media surgery, wherein the rf ablation electrode adopts the third method described above, comprising the following steps:
s1, attaching physiological saline to the electrode head end of the handheld radio-frequency ablation electrode;
s2, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s3, turning on a power switch of the electrode, switching on the power of the electrode, enabling the physiological saline at the head end of the electrode to conduct the inner tube electrode and the outer tube electrode, generating a plasma field, and continuing to propel the electrode to enable the plasma field to ablate and perforate the tympanic membrane;
and S4, closing a power switch of the electrode, and taking out the endoscope and the electrode.
Another method for using the rf ablation electrode for minimally invasive otitis media surgery, wherein the rf ablation electrode adopts the fourth method described above, and comprises the following steps:
s1, enabling the water absorption material to absorb enough physiological saline;
s2, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s3, turning on a power switch of the electrode, switching on the power of the electrode, enabling the physiological saline at the head end of the electrode to conduct the inner tube electrode and the outer tube electrode, generating a plasma field, and continuing to propel the electrode to enable the plasma field to ablate and perforate the tympanic membrane;
and S4, closing a power switch of the electrode, and taking out the endoscope and the electrode.
Another method for using the rf ablation electrode for minimally invasive otitis media surgery, wherein the rf ablation electrode adopts the fifth method, and comprises the following steps:
s1, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s2, turning on a power switch of the electrode and a water injection control switch of the physiological saline, enabling the physiological saline to reach the head end of the electrode through a hollow pipeline of the inner tube electrode, conducting the inner tube electrode and the outer tube electrode, generating a plasma field, and continuously propelling the electrode to enable the plasma field to perform ablation and perforation on the tympanic membrane;
and S3, closing a power switch of the electrode and a water injection control switch of the physiological saline, and taking out the endoscope and the electrode.
Compared with the prior art, the invention has the following advantages:
the invention provides a radio frequency ablation bipolar electrode specially used in otitis media minimally invasive surgery, which breaks through the thinking set of the traditional surgery modes such as mechanical puncture and laser puncture, utilizes the plasma principle to lead the inner tube electrode and the outer tube electrode to be conducted by normal saline between the ends of the inner tube electrode and the outer tube electrode, forms a plasma field at the electrode tip end to perform ablation and perforation on tympanic membrane tissues, has the temperature of 40-70 degrees on the tissues due to the action of the plasma field, does not form permanent burn on the tissues, and heals slower than the wounds punctured by the mechanical puncture, in fact, according to clinical experiments, the healing time of the plasma ablation perforation is about 1-3 months, is matched with the time required by effusion discharge, the healing time can be just used for effusion discharge, and the defect that the prior art can not be punctured repeatedly or healed is avoided, the efficiency and the treatment effect of the otitis media minimally invasive surgery are improved, the physical injury and pain of a patient are reduced, and the operation difficulty and the operation risk of the surgery are reduced. Meanwhile, because the plasma field formed by the physiological saline is actually contacted with the tissues, the rigid metal at the head end of the electrode does not contact the tissues, but has a distance of about 0.5mm with the tissues of the tympanic membrane, and the possible burns or mechanical damages of the tissues caused by the metal can be avoided. In addition, the physiological saline has the functions of cooling, resisting bacteria and inflammation and protecting the wound surface in the operation process, so that the operation risk is further reduced, and the safety and the postoperative recovery effect are improved.
In addition, the size of the electrode head end is designed, so that when the tympanic membrane tissue is ablated and punched, the punching depth can be controlled, the internal nerve is not injured, and the operation accident is avoided.
In conclusion, the radio frequency ablation electrode can complete the whole operation process under the visual condition with the assistance of the endoscope, has ideal puncture effect, small damage to tympanic membrane tissues and good healing effect, achieves the aims of safe operation, higher efficiency and quick postoperative function recovery compared with the traditional otitis media puncture operation, reduces the negative effect to the minimum level, brings good medical market and obtains objective economic and social benefits.
Drawings
FIG. 1 is a schematic overall structural view of a radio frequency ablation electrode of an embodiment of the present invention;
FIG. 2 is a schematic diagram of an overall cross-sectional configuration of a radio frequency ablation electrode in accordance with an embodiment of the present invention;
FIG. 3 is a schematic cross-sectional view of portion A in FIG. 2, illustrating a first embodiment of the positional relationship between layers of the electrode tip according to the embodiment of the present invention;
FIG. 4 is a schematic perspective view of an electrode tip corresponding to FIG. 3;
FIGS. 5 and 6 are schematic sectional and perspective views of a second embodiment of an electrode tip according to an embodiment of the present invention;
FIGS. 7 and 8 are schematic sectional and perspective views of a third embodiment of an electrode tip according to an embodiment of the present invention;
FIG. 9 is a schematic structural diagram of an electrode fixing ring according to an embodiment of the present invention;
fig. 10 is a schematic sectional view taken along B-B in fig. 9.
Detailed Description
As shown in figures 1 and 2, the embodiment provides a radio frequency ablation electrode for minimally invasive otitis media surgery, which comprises a handle, an
Specifically, referring to fig. 3-8, the
The position relation of the head ends of the
the first solution, as shown in figures 3 and 4: the head end of the insulating
The second solution, as shown in fig. 5 and 6: the head end of the insulating
The third scheme, as shown in fig. 7 and 8: the head end of the
In terms of radial dimensions, the electrodes of the present invention include pediatric and adult versions. The radial dimensions of the parts of the children money are as follows: the outer diameter of the inner tube electrode is 0.5-1.5mm, and the outer diameter of the heat shrinkable tube, namely the outer diameter of the electrode rod of the electrode, is 0.9-2.9 mm; the radial dimensions of the various parts in the adult version are as follows: the outer diameter of the inner tube electrode is 0.6-1.6mm, and the outer diameter of the heat shrinkable tube, namely the outer diameter of the electrode rod of the electrode, is 1.2-3.2 mm. Preferably, the heat shrinkable tube for children is 1.9mm in outer diameter, and the heat shrinkable tube for adults is 2.2mm in outer diameter.
An electrode fixing ring is arranged at a certain length between the tail end and the head end of the
In fact, the electrode fixing ring can be designed into a plurality of electrode fixing rings, namely, one electrode fixing ring is arranged at each of different lengths of the electrodes; moreover, the outer tube electrode is concave, and in practical use, a plurality of outward protruding salient points can be uniformly arranged along the circumferential direction of the inner tube electrode and the insulating tube coated outside the inner tube electrode, and the vertexes of the plurality of salient points are abutted to the inner surface of the outer tube electrode; in each scheme, the concave point of the outer tube electrode or the convex point of the inner tube electrode can not be completely abutted against the outer wall of the insulating tube or the inner wall of the outer tube electrode, and the two are close to each other, so that the relative fixation of the inner tube electrode and the outer tube electrode can be realized, and the effect is only slightly poor; furthermore, instead of the electrode fixing ring, a plurality of electrode fixing points, that is, the above-described concave points or convex points, may be provided, as long as the plurality of electrode fixing points are distributed in the radial direction and the axial direction of the electrode, so that the inner tube electrode and the outer tube electrode can be relatively fixed.
As shown in fig. 2, the handle of the present embodiment includes a
The
Preferably, the radiofrequency ablation electrode of the embodiment further comprises a foot switch, wherein the foot switch is a power switch of the
The present invention is not limited to the structure described in the embodiment, and various modifications are possible, such as:
1. a water injection pipe is communicated with the annular gap without a water suction pipe, and the physiological saline reaches the electrode tip end through the water injection pipe and the annular gap in sequence to form a plasma field to perform ablation and punching on the tympanic membrane without backflow, wherein the inner tube electrode can be a solid tube under the condition;
2. the water injection pipe is not arranged, the water suction pipe is communicated with the inner pipe electrode and is attached to the electrode head end in advance, namely the normal saline between the electrode head end of the inner pipe electrode and the electrode head end of the outer pipe electrode forms a plasma field to perform ablation and punching on the tympanic membrane and is sucked out to the water suction pipe by the inner pipe electrode, and under the condition, the outer pipe electrode and the insulating pipe outside the inner pipe electrode can be in direct contact without a gap;
3. the water injection pipe and the water suction pipe are not arranged, the physiological saline pre-attached to the head end of the electrode forms a plasma field to perform ablation and perforation on the tympanic membrane, and the physiological saline can form the plasma field at the end of the electrode tip;
4. the electrode is characterized in that a water injection pipe and a water suction pipe are not arranged, a water absorption material is arranged between the insulating pipe and the outer pipe electrode, sufficient physiological saline pre-absorbed in the water absorption material is attached to the physiological saline at the head end of the electrode to form a plasma field to perform ablation and perforation on the tympanic membrane, and the inner pipe electrode can also be a solid pipe under the condition that the physiological saline can form the plasma field at the end of the electrode tip;
5. the inner tube electrode is a water injection channel and is communicated with the water injection pipe, and a water absorption channel is not arranged: the inner tube electrode is a hollow tube, a water injection tube and the hollow pipeline of the inner tube electrode are communicated, and the physiological saline reaches the head ends of the inner tube electrode and the outer tube electrode after passing through the hollow pipelines of the water injection tube and the inner tube electrode, and forms a plasma field to melt and perforate the tympanic membrane under the action of an electromagnetic field between the two poles.
In several cases, the function and connection of the foot switch are adjusted accordingly. In the electrode without the water injection tube, since the physiological saline needs to be attached to the electrode tip in advance, the positional relationship among the tips of the inner tube electrode, the insulating tube, the outer tube electrode, and the heat shrinkable tube is not suitable for the first solution described above. The 5 th configuration is also not applicable to the first solution described above.
The annular gap can be a gap with other cross sections, and physiological saline can pass through the annular gap.
The use method of the radio frequency ablation electrode for otitis media minimally invasive surgery of the embodiment comprises the following steps:
s1, holding the ear canal endoscope by one hand and holding the handle of the radio frequency ablation electrode by the other hand, and sending the electrode into the ear canal until the electrode is close to the tympanic membrane under the auxiliary action of the ear canal endoscope;
s2, firstly, turning on a water injection and water absorption control switch of the electrode normal saline, enabling the normal saline to reach the head end of the electrode through a gap between an outer tube electrode and an insulating tube outside the inner tube electrode to form a connecting water droplet, then stepping on a foot switch to conduct the inner tube electrode and the outer tube electrode to generate a plasma field, and continuously propelling the electrode to enable the plasma field to melt and perforate the tympanic membrane, and meanwhile, enabling the normal saline to be continuously sucked out through a hollow pipeline of the inner tube electrode;
s3, releasing the pedal switch, and taking out the endoscope and the electrode.
If the water suction pipe is not arranged, the use method of the radio frequency ablation electrode for the otitis media minimally invasive surgery comprises the following steps:
s1, holding the ear canal endoscope by one hand and holding the handle of the radio frequency ablation electrode by the other hand, and sending the electrode into the ear canal until the electrode is close to the tympanic membrane under the auxiliary action of the ear canal endoscope;
s2, stepping on the foot switch to switch on the power supply of the electrode, simultaneously conveying the physiological saline to a water injection port at the head end of the annular gap, conducting the inner tube electrode and the outer tube electrode to generate a plasma field, and continuously propelling the electrode to enable the plasma field to ablate and perforate the tympanic membrane;
s3, releasing the pedal switch, and taking out the endoscope and the electrode.
If the water injection pipe and the water suction pipe are not arranged, the use method of the radio frequency ablation electrode for the otitis media minimally invasive surgery comprises the following steps:
s1, attaching physiological saline to the electrode tip of the handheld radio-frequency ablation electrode as much as possible;
s2, holding the ear canal endoscope by one hand and holding the handle of the radio frequency ablation electrode by the other hand, and sending the electrode into the ear canal until the electrode is close to the tympanic membrane under the auxiliary action of the ear canal endoscope;
s3, stepping on the foot switch, switching on the power supply of the electrode, enabling the physiological saline at the head end of the electrode to conduct the inner tube electrode and the outer tube electrode, generating a plasma field, and continuously propelling the electrode to enable the plasma field to ablate and perforate the tympanic membrane;
s4, releasing the pedal switch, and taking out the endoscope and the electrode.
If the hollow channel of the inner tube electrode is used as a water injection channel, the use method of the radio frequency ablation electrode for the otitis media minimally invasive surgery comprises the following steps:
s1, holding the auditory canal endoscope by one hand and holding the handle of the radio-frequency ablation electrode by the other hand, and sending the electrode into the auditory canal under the auxiliary action of the auditory canal endoscope until the head end of the electrode is close to the position of the tympanic membrane;
s2, a foot switch is stepped on, the power supply of the electrode is switched on, the physiological saline reaches the head end of the electrode through a hollow pipeline of the inner tube electrode, the inner tube electrode and the outer tube electrode are conducted, a plasma field is generated, the electrode is continuously pushed, and the plasma field is used for ablating and punching the tympanic membrane;
s3, releasing the pedal switch, and taking out the endoscope and the electrode.
It should be noted that, for a person skilled in the art, several variations and modifications can be made without departing from the inventive concept, which falls within the scope of the present invention. Therefore, the protection scope of the present patent shall be subject to the appended claims.
- 上一篇:一种医用注射器针头装配设备
- 下一篇:一种医用泡沫金属换热器的低温探针